From the Guidelines
Rifaximin is indicated for the treatment of Irritable Bowel Syndrome with Diarrhea (IBS-D) and Hepatic Encephalopathy (HE).
Indications for Rifaximin
- Irritable Bowel Syndrome with Diarrhea (IBS-D): Rifaximin is suggested for use in patients with IBS-D, with a conditional recommendation and moderate certainty of evidence 1.
- Hepatic Encephalopathy (HE): Rifaximin may be combined with non-absorbable disaccharides to treat patients with HE, with a recommendation based on moderate evidence 1.
- Traveler's Diarrhea (TD): Rifaximin has been shown to confer strong protection against TD, with a favorable safety profile, although its effectiveness may be moderate in regions where Campylobacteriosis is common 1.
Dosage and Administration
- The typical dosage of rifaximin for IBS-D is 550 mg, thrice daily for 2 weeks 1.
- For HE, the dosage and duration of rifaximin treatment may vary, and it is often used in combination with other therapies 1.
- For TD, prophylactic rifaximin has been studied at doses of 200 to 1100 mg per day, divided into one to three doses 1.
Important Considerations
- Rifaximin is a broad-spectrum antibiotic, and its use should be restricted to difficult cases to minimize the risk of promoting antibiotic resistance 1.
- The efficacy and safety of rifaximin in different regions and populations may vary, and it is essential to consider these factors when making treatment decisions 1.
From the FDA Drug Label
XIFAXAN is a rifamycin antibacterial indicated for: • Treatment of travelers’ diarrhea (TD) caused by noninvasive strains of Escherichia coli in adult and pediatric patients 12 years of age and older (1.1) • Reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults (1.2) • Treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults (1. 3)
The indications for Rifaximin are:
- Treatment of travelers’ diarrhea caused by noninvasive strains of Escherichia coli in adult and pediatric patients 12 years of age and older
- Reduction in risk of overt hepatic encephalopathy recurrence in adults
- Treatment of irritable bowel syndrome with diarrhea in adults 2
From the Research
Indications for Rifaximin
The indications for Rifaximin are varied and include:
- Hepatic encephalopathy (HE) prevention and treatment 3, 4, 5
- Traveler's diarrhea 4, 6, 7
- Irritable bowel syndrome (IBS), particularly diarrhea-predominant IBS 4, 5, 7
- Small intestine bacterial overgrowth (SIBO) 6, 7
- Inflammatory bowel disease (IBD) 4, 6
- Clostridium difficile infection (CDI) 5, 7
- Symptomatic uncomplicated diverticular disease 7
- Prevention of spontaneous bacterial peritonitis in liver cirrhosis patients 6
Potential Indications
Some potential indications for Rifaximin that are still being researched include: